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R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. The Inpatient Coding Quality Reviewer will be responsible for reviewing inpatient coded cases for coding completeness and accuracy. This person will identify potential coding and DRG errors, researches appropriate guidelines to support recommended changes, and communicates the changes to the coder involved on a timely basis. The Reviewer provides expert coding advice to coding staff and relays needed coding educational topics to the Regional Manager, IP Coding Quality. This role will report to the Regional Manager of Inpatient Coding Quality. Here’s what you will experience working as a (Inpatient Coding Quality Reviewer): <ul> <li>Review inpatient coded cases for coding completeness and accuracy. </li> <li>Identify potential coding and DRG errors, research appropriate guidelines to support recommended changes, and communicate changes to the coder involved on a timely basis. </li> <li>Provide expert coding advice to coding staff and relay needed coding educational topics to the Regional Manager, IP Coding Quality. </li> <li>Conduct daily pre-bill review of cases flagged by the PwC SMART coding quality monitoring software tool. </li> <li>Maintain required productivity standards and high-quality results. </li> <li>Audit records as defined in the coding quality review plan. </li> <li>Review cases flagged by the coding quality software on a daily basis for multiple hospitals. </li> <li>Validate the completeness of documentation, identify missed diagnoses and procedures, propose physician queries, and ensure the accuracy of diagnoses, procedures, POA, discharge disposition, and DRG assignment. </li> <li>Perform retrospective coding quality reviews as requested. </li> <li>Maintain up-to-date knowledge of industry coding and documentation guidelines to ensure system-wide coding consistency and compliance. </li> <li>Communicate audit findings with coders in a timely manner and support teams in addressing and resolving local coding issues. </li> <li>Serve as an inpatient coding expert and resource for the coding teams and other departments. </li> <li>Work with the Regional Manager to identify areas of educational need based on audit results. </li> <li>Assist with evaluation and testing of audit applications and updates as needed. </li> <li>Work with the hospital’s CDI team to address and resolve documentation issues. </li> <li>Assist with compilation, generation, and analysis of data for results reporting and performance improvement initiatives. </li> <li>Contribute to the reduction of the hospital's and Company’s coding compliance risks and revenue enhancement goals. </li> <li>Maintain an open dialogue and a good working relationship with team members. </li> <li>Assist with training of new auditors and other audits and duties as requested. </li> </ul> Required Skills: <ul> <li>Bachelor's or Associate's Degree with CCS credential. </li> <li>A minimum of seven (7) years of hospital inpatient coding experience. </li> <li>Extensive knowledge of ICD-10-CM/PCS classification system and MS-DRG and APR-DRG methodologies. </li> <li>In-depth knowledge of medical terminology, human anatomy/physiology, pharmacology, and pathology. </li> <li>Expert knowledge of industry Official Coding and Reporting Guidelines, CMS, and other agency directives for ICD-10 coding. </li> <li>Proficient MS Office computer skills, specifically in Excel, and knowledge of various coding software/platforms and EMRs. </li> <li>Detail-oriented with the ability to work independently and maintain a high productivity rate and coding accuracy rate. </li> <li>Effective communication skills and a self-starter attitude. </li> </ul> Desired Qualifications: <ul> <li>Two (2) years of inpatient coding audit experience. </li> <li>Experience in a large (&gt; 500 beds) hospital or multi-hospital health system. </li> <li>Training in hospital Clinical Documentation Improvement. </li> <li>Experience as a Coding Consultant with a consulting firm. </li> </ul> For this US-based position, the base pay range is $18.69 - $39.35 per hour . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>#remote #healthcare #tj2022

R1 RCM

US-Coding Assoc III

R1 is a leading provider of technology-driven solutions that enhance the patient experience and improve the financial performance of hospitals, health systems, and medical groups. We uniquely combine the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, which includes sophisticated analytics, AI, intelligent automation, and workflow orchestration.As a Senior Operations Lead, you will partner with site leaders and Shared Service teams to uncover process improvement opportunities, reduce defects, and deliver meaningful, customer-ready solutions. Your daily responsibilities will include conducting financial analyses, creating performance reports, designing process flows, and building strong client relationships, all while showcasing outstanding communication and problem-solving abilities. If you excel under pressure, embrace uncertainty, and are eager to drive meaningful change, this role provides an exciting opportunity to innovate and lead with impact.Here’s What You Can Expect<ul> <li>Collaborate with the Performance Management team, site leaders, and Shared Service teams to identify process improvement opportunities and minimize defects.</li> <li>Leverage revenue cycle expertise to produce customer-ready deliverables and demonstrate sound judgment in problem-solving.</li> <li>Conduct financial analyses, prepare performance reports, design process flows, and facilitate group meetings to support operational excellence.</li> <li>Build and maintain strong client relationships while showcasing exceptional communication and analytical skills.</li> <li>Work both independently and collaboratively in a highly matrixed environment to drive impactful solutions.</li> <li>Use data to generate insights, monitor Key Performance Indicators (KPIs), and ensure alignment with company financial commitments.</li> <li>Develop innovative process solutions through automation and standardization while participating in cross-functional discussions to improve KPI performance.</li> </ul>Requirements:<ul> <li>Bachelors degree preferred or extensive experience in revenue.</li> <li>Proven ability to look at the world through the eyes of others and interpret business needs in a way that drives the success of others</li> <li>Attention to detail, highly organized and strong process-focused aptitude</li> <li>Possess strong leadership and organizational skills and can positively influence others</li> <li>Ability to think creatively, be analytically minded, objective, and independent</li> <li>Demonstrated ability to negotiate and provide alternative business solutions</li> <li>Proficiency in Excel and PowerPoint</li> <li>Outstanding time management skills and the ability to simultaneously manage multiple tasks while remaining self-directed</li> </ul>For this US-based position, the base pay range is $47,237.00 - $78,919.86 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.This job is eligible to participate in our annual bonus plan at a target of 5.00%The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>#LI-KW01 #Leadership #TJ2022 #RCM #ProjectManagement

Senior Operations Lead

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems, and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our Clinical Appeals Supervisor, you will help support clinicians who conduct a comprehensive review of clinical denials and formulate appeals based on clinical documentation, evidence-based medical necessity criteria, physician documentation, and medical policies of the payor. Every day you will supervise the day-to-day clinical operations and functions within the department, ensuring productivity and quality metrics are met and regularly identify and communicate denial trends and patterns to leadership. To thrive in this role, you must have experience supervising in a clinical inpatient environment and the ability to use sound judgment in reviewing clinical documentation supporting patient care as well as conceptual knowledge of the denials landscape. Proficiency in basic computer skills is essential for excelling in this remote position.Here’s what you will experience working as a Clinical Appeals Supervisor:<ul> <li>Track and monitor the workflow of the clinical team daily to ensure internal and external compliance deadlines are met.</li> <li>Track clinicians’ productivity and quality by performing regular audits of appeals. Evaluate and report on overturned appeals to continuously refine clinical practices and ensure optimal outcomes.</li> <li>Assess the viability of cases for external review or escalation, as well as make final determinations on clinical appeals that require no further action.</li> <li>Act as a liaison for non-clinical staff and attorneys to collaborate on appeals processing.</li> <li>Leverage employee engagement data to identify targeted areas for additional support and engagement.</li> </ul>Required Skills:<ul><li>Active Registered Nurse license</li></ul>For this US-based position, the base pay range is $84,456.00 - $139,823.91 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.This job is eligible to participate in our annual bonus plan at a target of 10.00%The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>#LI-AC01

Clinical Appeals Supervisor

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our Hospital Coding Auditor, you will review hospital charges against medical record and all applicable documentation to determine appropriate code assignments on services provided (CPT/HCPCS codes). The Auditor must have a comprehensive understanding of medical terminology, coding, contractual agreements, and various payment methodologies. This position requires good time management skills and the ability to work independently. Here’s what you will experience working as a Hospital Coding Auditor <ul> <li>Review hospital charges against medical record and all applicable documentation to determine appropriate code assignments on services provided (CPT/HCPCS codes) </li> <li>Understand billing and coding requirements for government and commercial payers. </li> <li>Abstract statistical data from the patient record and enter information following facility guidelines. </li> </ul><ul> <li>Follow all HIPAA regulations and uphold a higher standard around privacy requirements. </li> <li>Maintain at least a 95% accuracy rate. </li> <li>Maintain productivity standards, tracking logs and deadlines. </li> </ul>To be successful in this role, you must have:<ul><li>CPC, CCS, CPC-H (COC), CPMA, CIC, RHIA, RHIT and/or CCS-P certification </li></ul><ul> <li>Experience in billing, charge documentation, charge audit or charge capture activities, or other functions related to revenue cycle activities. </li> <li>Experience coding multi-specialties preferred that may include trauma, orthopedics, cardiology, interventional radiology, and neurology. </li> <li>Must possess a demonstrated knowledge of clinical processes; clinical coding (CPT, HCPCS, ICD-10, revenue codes, status indicators, and modifiers), charging processes and audits. </li> </ul><ul> <li>Knowledge of CMS guidelines, Ambulatory Payment Classification, and Outpatient Prospective Payment System, reimbursement structures and prebill edits including Outpatient Coding Edits/Correct Coding Initiative edits preferred. </li> <li>Experience with encoder technology and electronic medical record systems. </li> <li>Ability to work in a flexible environment, adapting to changing priorities.</li> <li>Excellent organizational skills and strong attention to detail</li> </ul>For this US-based position, the base pay range is $43,888.00 - $70,631.44 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.This job is eligible to participate in our annual bonus plan at a target of 5.00%The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>

Hospital Coding Auditor

Job Description R1 RCM Inc. is a leading provider of technology-enabled revenue cycle management services which transform and solve challenges across health systems, hospitals and physician practices. Headquartered in Chicago, R1® is a publicly-traded organization with employees throughout the US and international locations. Our mission is to be the one trusted partner to manage revenue, so providers and patients can focus on what matters most. Our priority is to always do what is best for our clients, patients and each other. With our proven and scalable operating model, we complement a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience. The Client Experience Director (CXD) will serve as one of the primary points of contact for all day-to-day activities within the Client Experience Team. The CXD will be responsible for establishing trusted relationships with their assigned clients, and when appropriate expand our partnerships through selling new solutions. This person will be responsible for providing support to the Client Experience Team to which they are assigned as well as collaborating across various departments within R1 to drive high client satisfaction and safeguard client retention. To thrive in this role, you must have a dynamic personality who approaches external relationships from the client’s perspective using effective and proactive communication, analytical skills, and daily leadership. The CXD will be tasked with various project leadership opportunities that require a high-level of cross-collaboration with multiple organization units. RESPONSIBILITIES <ul> <li>Client Relationship/Management: 30%</li> <li>Collaboration with other R1 functions: 30%</li> <li>Client Business Reviews and Meetings: 20%</li> <li>Introducing and selling new solutions to existing clients, including having a target sales quota: 15%</li> <li>Document the client experience in CRM: 5%</li> <li>Drive high Net Promoter Score (NPS) results across their client portfolio.</li> <li>Work collaboratively across functions to ensure operational excellence to nurture and ensure client satisfaction leads to growth and retention.</li> <li>Ensure mutual understanding of goals, objectives and action plans related to client’s revenue and book of business.</li> <li>Participate in the contracting and contract renewal process.</li> <li>Contribute to region and client-level strategic planning.</li> <li>Lead the creation and presentation of business reviews.</li> <li>Assist in the implementation of new solutions and onboarding of new clients.</li> <li>Follow best-practice account management and client experience methodologies.</li> </ul> REQUIRED QUALIFICATIONS <ul> <li>4+ years of account management, client experience management, and/or revenue cycle operations consulting experience working with Director-level partners is preferred.</li> <li>Healthcare revenue cycle and revenue integrity experience working with acute care provider organizations.</li> <li>Outstanding organization and prioritization skills</li> <li>Exceptional written and verbal communication skills</li> <li>Bachelor’s degree</li> <li>Proficiency with Microsoft Office, including basic to intermediate Excel functions, and CRM application use (preferred: Salesforce)</li> <li>Ability to travel up to 40%</li> </ul> For this US-based position, the base pay range is $109,118.00 - $187,269.24 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>

Director of Client Success

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems, and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our Clinical Coding Appeals Nurse, you will help review and interpret medical records to draft appeals of denied and underpaid claims. Every day you will review medical records to ensure appropriate coding of removed or revised diagnosis and procedure codes. Then you will draft appeal letters based on clinical judgment and knowledge and make coding change suggestions to our clients based on ICD-9/10 CM &amp; PCS, CPT, HCPCS, and NCCI guidance. To thrive in this role, you must have experience identifying different types of hospital documentation including, but not limited to, medical records, UB-04s, EOBs, itemized bills, hospital account notes, appeal letters, and denial/approval letters. Proficiency in basic computer skills is essential for excelling in this remote production-drive position.Here’s what you will experience working as a Clinical Coding Appeals Nurse:<ul> <li>Review and interpret medical records to appeal denied and underpaid claims.</li> <li>Apply clinical judgment and knowledge for DRG downgrades performed because of a Clinical Validation Review by an insurer or third-party auditor.</li> <li>Draft appeal letters that are well-written, logically structured, and persuasive, utilizing ICD-9/10 CM &amp; PCS, CPT, HCPCS, NCCI guidance.</li> <li>Ensure that all appeals are completed timely to ensure internal and external compliance deadlines are met.</li> </ul>Required Skills:<ul> <li>Active Registered Nurse license</li> <li>An active CCS, RHIA, RHIT, CCA, CPC-A, CPC-H, COC, CPMA, CIC, CDI, or CDIP certification OR 2+ years of CDI experience</li> </ul>For this US-based position, the base pay range is $69,556.00 - $114,234.05 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.This job is eligible to participate in our annual bonus plan at a target of 10.00%The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>#LI-AC01

Clinical Coding Appeals Nurse

At R1 RCM we are a leading provider of technology-driven solutions that transform the patient experience and financial performance of healthcare providers. We deliver proven ROI across the entire revenue cycle – front, middle and back office. This enables our customers to achieve an optimal revenue cycle – one that promotes patient satisfaction and improves financial performance.As our DRGV Auditor II, your primary role will be auditing inpatient cases for DRG validation and/or documentation improvement. This consists of reviewing accounts in proprietary software and client EMR systems to validate the accounts. Opportunity for growth includes a client facing Lead Auditor role and an internally facing Mentor role. Every day in this role you will:<ul> <li>Review inpatient medical records for validation of DRG assignment </li> <li>Provide detailed rationale and supporting evidence for recommendation and findings </li> <li>Utilize industry-recognized references to support their review findings, such as the ICD-10 Official Guidelines for Coding and Reporting, AHIMA Standards of Ethical Coding, AHIMA Practice Briefs related to compliant querying, and AHA Coding Clinics </li> </ul>To succeed in this role, you must have:<ul> <li>Current AHIMA credentials of one or more of the following are required: RHIA, RHIT, and/or CCS </li> <li>3+ years of ICD-10 auditing and DRG reimbursement experience, with recent acute inpatient auditing experience </li> </ul>For this US-based position, the base pay range is $51,700.00 - $95,429.25 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.This job is eligible to participate in our annual bonus plan at a target of 5.00%The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>

DRGV Auditor II

R1 RCM Inc. is a leading provider of technology-enabled revenue cycle management services which transform and solve challenges across health systems, hospitals and physician practices. Headquartered in Chicago, R1® is a publicly-traded organization with employees throughout the US and international locations. Our mission is to be the one trusted partner to manage revenue, so providers and patients can focus on what matters most. Our priority is to always do what is best for our clients, patients and each other. With our proven and scalable operating model, we complement a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience. As the Government Navigation Services (GNS) Business Development Director, you will focus on engaging and targeting new Tier 1 and Tier 2 target accounts (i.e., high-value prospects). On a day-to-day basis, in addition to prospecting and networking initiatives, the GNS Business Development Director will partner with the Business Development teams of in-house and outsourced lead generation professionals to build an active sales funnel (i.e., sales staged Qualified and above) with booking values equal to or greater than sales quota in estimated first-year revenue.To thrive in this role, you will utilize your expertise in Medicare reimbursement, specifically Medicare Bad Debt, Disproportionate Share (DSH), and Worksheet S-10 (Uncompensated Care) to navigate development discussions with prospective clients. Responsibilities:<ul> <li>Develop and execute a strategy that aligns with company objectives to rapidly build brand awareness and drive new revenue</li> <li>Navigate Government Reimbursement</li> <li>Meet or exceed annual goals as assigned</li> <li>Accurately forecast attainment on a monthly, quarterly, and annual basis</li> <li>Ensure sales activity is documented correctly through the CRM automation tool (Salesforce)</li> <li>Collaborate in a team selling environment to identify, pursue and capture new client relationships. </li> <li>Build trusting relationships with potential clients</li> </ul> Requirements:<ul> <li>10+ years of experience selling services surrounding Medicare reimbursement, combined with a strong/effective presence with hospital and health systems' various leadership teams and executives, including the C-suite, with a proven ability to develop relationships and gain buy-in</li> <li>Experience navigating Medicare reimbursement</li> <li>Expertise in Medicare Bad Debt, DSH, Worksheet S-10</li> <li>Ability to travel up to 50%</li> </ul>For this US-based position, the base pay range is $116,133.00 - $173,605.10 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>

Business Development Director-Government Reimbursement

Location: Remote, US Hours: Shift-based schedule spanning 6am-2am CT, 7 days a week, including holidays and weekends R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our EMR Specialist, you will be responsible for assisting physicians by pulling patient records from EMR systems. Every day you will review customer records and upload them into a portal. To thrive in this role, prior experience with electronic health information systems, procedures and control techniques associated with confidentiality, integrity and functional knowledge of network defenses, and HIPPA laws and policies is preferred. Attention to detail and proficiency in basic computer skills is essential for excelling in this remote, production-driven position.Here’s what you will experience working as an EMR Specialist:<ul> <li>Maintain working EMR access for navigation and basic troubleshooting.</li> <li>Perform accurate and thorough data entry while maintaining productivity standards.</li> <li>Maintain communication with physician teams regarding cases, case completion, and portal workflow.</li> <li>Attach pertinent clinical information to portal cases and follow cases to completion within service level agreements.</li> </ul>For this US-based position, the base pay range is $16.88 - $25.51 per hour . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>#LI-AC01

EMR Specialist

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. The OBGYN Coding Associate II will be responsible for reviewing clinical documentation and diagnostic results as appropriate (i.e., to extract data and apply appropriate ICD-10-CM, HCPCS and CPT-4 codes for billing, review and correct billing edits, internal and external reporting, research, and regulatory compliance). Under the direction of the Coding Leadership Team, the successful candidate must be able to accurately code conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting.Here's what you can expect as our OBGYN Coding Associate II:<ul> <li>Assigns codes for diagnoses, treatments and procedures according to the appropriate classification system for professional service encounters to determine the highest level of specificity ICD-10 codes, CPT codes, HCPCS codes, and modifiers.</li> <li>Reviews physician assigned diagnosis code after thorough review of the medical record and, if necessary, queries physician for additional clarity in a professional manner.</li> <li>Able to accurately abstract information from the medial records into the abstract system, according to established guidelines.</li> <li>Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and American Academy of Professional Coders (AAPC) adheres to official coding guidelines</li> <li>Enters and validates codes, charges and other edits flagged in Athena or EPIC for review.</li> <li>Review documentation (and returned accounts) to verify and correct place of service, billing and service providers, or other missing data elements (ie: NDC #, or number of units)</li> <li>Uses CCI edit software to check bundling issues, modifier appropriateness, and LCD’s/NCD’s for medical necessity.</li> <li>Communication with other departments to recommend coding guidance for charge corrections, appeals processes, and patient billing concerns.</li> <li>Meet and/or exceeds the established coding productivity standards</li> <li>Meet and/or exceeds the established quality standard of 95% accuracy while meeting and/or exceeding productivity standards</li> </ul> Required Qualifications:<ul> <li>High School Diploma or GED required CCS-P, CPC</li> <li>Two (2) years of OB-GYN experience</li> <li>Must be able to demonstrate proficiency in professional services (95% accuracy).</li> <li>Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA) (ie: Documentation Guidelines ’95 &amp; ’97)</li> <li>Extensive knowledge of government, and commercial payer guidelines.</li> <li>Must be able to use standard office equipment and information systems.</li> <li>Ability to interact with other employees through effective communication.</li> <li>Ability to prioritize and shift workloads to ensure departmental goals align with revenue cycle goals </li> </ul>For this US-based position, the base pay range is $17.58 - $27.14 per hour . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>

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